Dimitra-Irinna Vitoratou, Eva Karaglani, Matzourana Argyropoulou, Konstantina Dimakopoulou, Violeta Iotova, Yuliya Bazdarska, Tsvetalina Tankova, Greet Cardon, Luis A. Moreno, Imre Rurik, Péter Torzsa, Jaana Lindström, Konstantinos Makrilakis, Yannis Manios
Background
Family-based interventions offer a promising solution to the pressing global health concern of childhood obesity by addressing the interconnected behaviours of parents and children. Nevertheless, limited evidence identifies which families benefit most when outcomes are evaluated at the parent–child dyad level.
Aim
To identify which parent–child dyads experienced clinically meaningful improvements in weight status over 1- and 2-year periods within the Feel4Diabetes study, a school- and community-based intervention targeting European families at risk for Type 2 diabetes.
Methods
Data were drawn from 2402 high-risk families across six European countries. For participants with overweight/obesity, improvement meant ≥ 5% parental weight loss and a ≥ 0.15-unit child BMI-z reduction. Multiple logistic regression models identified socio-demographic and contextual predictors of dyadic improvement.
Results
After 2 years, 5.3% of families achieved improvements in both parent and child. Significant predictors of dyadic success included intervention group participation [OR = 2.56 (95% CI: 1.31–5.03)] and residing in high-income countries under austerity measures [OR = 2.44 (1.00–6.02)]. Girls were more likely to improve than boys, while full-time maternal employment was associated with lower odds of dyadic improvement.
Conclusions
Sustained benefits were observed in a subset of families, highlighting the need for tailored, context-sensitive family-centred obesity prevention strategies.
{"title":"Who Benefited Most? Identifying Parent–Child Dyads With Improved Weight Outcomes in the Feel4Diabetes Study","authors":"Dimitra-Irinna Vitoratou, Eva Karaglani, Matzourana Argyropoulou, Konstantina Dimakopoulou, Violeta Iotova, Yuliya Bazdarska, Tsvetalina Tankova, Greet Cardon, Luis A. Moreno, Imre Rurik, Péter Torzsa, Jaana Lindström, Konstantinos Makrilakis, Yannis Manios","doi":"10.1111/ijpo.70159","DOIUrl":"10.1111/ijpo.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Family-based interventions offer a promising solution to the pressing global health concern of childhood obesity by addressing the interconnected behaviours of parents and children. Nevertheless, limited evidence identifies which families benefit most when outcomes are evaluated at the parent–child dyad level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify which parent–child dyads experienced clinically meaningful improvements in weight status over 1- and 2-year periods within the Feel4Diabetes study, a school- and community-based intervention targeting European families at risk for Type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were drawn from 2402 high-risk families across six European countries. For participants with overweight/obesity, improvement meant ≥ 5% parental weight loss and a ≥ 0.15-unit child BMI-<i>z</i> reduction. Multiple logistic regression models identified socio-demographic and contextual predictors of dyadic improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 2 years, 5.3% of families achieved improvements in both parent and child. Significant predictors of dyadic success included intervention group participation [OR = 2.56 (95% CI: 1.31–5.03)] and residing in high-income countries under austerity measures [OR = 2.44 (1.00–6.02)]. Girls were more likely to improve than boys, while full-time maternal employment was associated with lower odds of dyadic improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sustained benefits were observed in a subset of families, highlighting the need for tailored, context-sensitive family-centred obesity prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy J. Renier, Delaina D. Carlson, Diane Gilbert-Diamond, Jennifer A. Emond
Background
The Child Eating Behaviour Questionnaire (CEBQ) measures multiple appetitive traits. We used a data-driven approach to identify simplified composite scores across traits to summarise obesogenic eating risk.
Methods
From 354 unrelated 9-to-12-year-olds, we examined 29 items from CEBQ domains measuring food approach or avoidance: food responsiveness, enjoyment of food, emotional over-eating, desire to drink, satiety responsiveness, slowness in eating, and emotional under-eating. Factor analysis assuming a single factor was used to reduce the number of items in one composite, obesogenic eating score. Candidate composite scores averaged items with standardized loadings ≥|0.40|, ≥|0.50|, or ≥|0.70|. Those scores, the individual domain scores, and a theory-driven composite score were correlated with BMI z-scores and two obesity polygenic risk scores (PRS, subset n = 247).
Results
The three data-driven composite scores (4–18 items) and the theory driven score were highly correlated with each other (r range: 0.77–0.97) and more strongly correlated with BMI (r range: 0.38–0.42; FDR q < 0.001) than any individual domain score. Similarly, these scores were significantly correlated with both PRSs.
Conclusions
We identified CEBQ composite scores related to child BMI and genetic obesity risk, suggesting a subset of CEBQ items can measure obesity risk conferred by child appetitive traits.
{"title":"Composite Summary Scores Capture Obesogenic Eating Risk Among Preadolescents Using the Child Eating Behaviour Questionnaire","authors":"Timothy J. Renier, Delaina D. Carlson, Diane Gilbert-Diamond, Jennifer A. Emond","doi":"10.1111/ijpo.70146","DOIUrl":"https://doi.org/10.1111/ijpo.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Child Eating Behaviour Questionnaire (CEBQ) measures multiple appetitive traits. We used a data-driven approach to identify simplified composite scores across traits to summarise obesogenic eating risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 354 unrelated 9-to-12-year-olds, we examined 29 items from CEBQ domains measuring food approach or avoidance: food responsiveness, enjoyment of food, emotional over-eating, desire to drink, satiety responsiveness, slowness in eating, and emotional under-eating. Factor analysis assuming a single factor was used to reduce the number of items in one composite, obesogenic eating score. Candidate composite scores averaged items with standardized loadings ≥|0.40|, ≥|0.50|, or ≥|0.70|. Those scores, the individual domain scores, and a theory-driven composite score were correlated with BMI z-scores and two obesity polygenic risk scores (PRS, subset <i>n</i> = 247).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The three data-driven composite scores (4–18 items) and the theory driven score were highly correlated with each other (<i>r</i> range: 0.77–0.97) and more strongly correlated with BMI (<i>r</i> range: 0.38–0.42; FDR <i>q</i> < 0.001) than any individual domain score. Similarly, these scores were significantly correlated with both PRSs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We identified CEBQ composite scores related to child BMI and genetic obesity risk, suggesting a subset of CEBQ items can measure obesity risk conferred by child appetitive traits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina N. Kim, Mary Jo Messito, Carol Duh-Leong, Michelle Katzow, Noelle Armstrong, Kathleen Woolf, Rachel S. Gross
Objective
Identify patterns of obesity-related prenatal characteristics across ecological system levels and examine associations with child weight at 2 years old.
Methods
Secondary analyses were conducted using data from 533 low-income Hispanic families enrolled in a childhood obesity prevention intervention. Prenatal characteristics were assessed during the 3rd trimester and child weights at 2 years. Latent class analysis was conducted to identify groups of pregnant individuals with different patterns of prenatal characteristics. Associations between class membership and child weight outcomes at age 2 years were examined using the manual Bolck–Croon–Hagenaars method, controlling for intervention status.
Results
Three groups were identified: Non-US born/Lower adverse SDOH (51%), Non-US born/Higher adverse SDOH (25%) and US born/Lower adverse SDOH (24%). Children of participants in the Non-US born/Higher adverse SDOH had significantly higher weight-for-age z-scores and higher odds of overweight or obesity compared to children of participants in the Non-US born/Lower adverse SDOH (Mdiff = 0.61, SE = 0.21, p = 0.003, 95% CI [0.27, 0.95]; aOR = 2.83, 95% CI [1.09, 2.59]) and Non-US born/Higher adverse SDOH burden (Mdiff = 0.55, SE = 0.20, p = 0.006, 95% CI [0.22, 0.89]; aOR = 2.83, 95% CI [1.09, 2.59]).
Conclusions
Higher concurrent levels of psychosocial stressors and material hardships during pregnancy may pose a particular risk for excess weight in early childhood, especially for children of non-US-born pregnant individuals.
目的确定跨生态系统水平的肥胖相关产前特征模式，并研究其与2岁儿童体重的关系。方法对参加儿童肥胖预防干预的533个低收入西班牙裔家庭的数据进行二次分析。在妊娠晚期评估产前特征和2岁时的婴儿体重。进行潜在分类分析以确定具有不同产前特征模式的怀孕个体群体。在控制干预状态的情况下，使用手动Bolck-Croon-Hagenaars方法检查班级成员与2岁儿童体重结果之间的关系。结果确定了三组：非美国出生/较低不良SDOH(51%)，非美国出生/较高不良SDOH（25%）和美国出生/较低不良SDOH（24%）。与非美国出生/不良SDOH较低的参与者的儿童相比，非美国出生/不良SDOH较高的参与者的儿童具有更高的年龄体重z分数和更高的超重或肥胖几率（Mdiff = 0.61, SE = 0.21, p = 0.003, 95% CI [0.27, 0.95]; aOR = 2.83, 95% CI[1.09, 2.59]）和非美国出生/不良SDOH负担(Mdiff = 0.55, SE = 0.20, p = 0.006, 95% CI [0.22, 0.89]；aOR = 2.83, 95% CI[1.09, 2.59])。结论：孕期较高水平的社会心理压力和物质困难可能会增加儿童早期超重的风险，特别是对于非美国出生的孕妇的孩子。
{"title":"Latent Class Analysis of Prenatal Characteristics and Their Associations With Early Childhood Weight","authors":"Christina N. Kim, Mary Jo Messito, Carol Duh-Leong, Michelle Katzow, Noelle Armstrong, Kathleen Woolf, Rachel S. Gross","doi":"10.1111/ijpo.70151","DOIUrl":"https://doi.org/10.1111/ijpo.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Identify patterns of obesity-related prenatal characteristics across ecological system levels and examine associations with child weight at 2 years old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary analyses were conducted using data from 533 low-income Hispanic families enrolled in a childhood obesity prevention intervention. Prenatal characteristics were assessed during the 3rd trimester and child weights at 2 years. Latent class analysis was conducted to identify groups of pregnant individuals with different patterns of prenatal characteristics. Associations between class membership and child weight outcomes at age 2 years were examined using the manual Bolck–Croon–Hagenaars method, controlling for intervention status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three groups were identified: <i>Non-US born/Lower adverse SDOH</i> (51%), <i>Non-US born/Higher adverse SDOH</i> (25%) and <i>US born/Lower adverse SDOH</i> (24%). Children of participants in the <i>Non-US born/Higher adverse SDOH</i> had significantly higher weight-for-age <i>z</i>-scores and higher odds of overweight or obesity compared to children of participants in the <i>Non-US born/Lower adverse SDOH</i> (<i>M</i><sub>diff</sub> = 0.61, SE = 0.21, <i>p</i> = 0.003, 95% CI [0.27, 0.95]; aOR = 2.83, 95% CI [1.09, 2.59]) and <i>Non-US born/Higher adverse SDOH burden</i> (<i>M</i><sub>diff</sub> = 0.55, SE = 0.20, <i>p</i> = 0.006, 95% CI [0.22, 0.89]; aOR = 2.83, 95% CI [1.09, 2.59]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher concurrent levels of psychosocial stressors and material hardships during pregnancy may pose a particular risk for excess weight in early childhood, especially for children of non-US-born pregnant individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Wittmann, Pia Späth, Feline Zocher, Eckard Nagel, Michael Lauerer, Magdalena Schellenberg
Background
Weight management and maintenance of healthy habits are crucial in combating paediatric obesity. This systematic review examines outcomes beyond BMI in teleintervention maintenance programmes, with a focus on sustaining a healthy lifestyle.
Methods
A PubMed, LIVIVO and Web of Science search was conducted for publications between 2012 and 4 November 2025 to identify primary studies evaluating teleintervention maintenance programmes of at least 12 weeks' duration, delivered to children and adolescents with overweight or obesity following structured obesity treatment. We extracted healthy lifestyle parameters (e.g., quality of life), behaviour change (e.g., diet) and clinician-reported outcomes (e.g., BMI). Quality assessment was tailored to study type. As data did not permit meta-analysis, we performed a narrative synthesis.
Results
Screening 2543 articles yielded 6 RCTs and 2 pre-post studies. Findings highlight improvements in psychosocial outcomes (e.g., social well-being), lifestyle modifications in daily choices (e.g., dietary patterns) and behaviours (e.g., screen time), and statistically significant outcomes including reductions in body fat percentage, metabolic profile improvements, cardiovascular enhancements and BMI stabilisation. Feasibility insights were also gained.
Conclusion
Teleintervention maintenance programmes following structured paediatric obesity treatment were associated with stabilisation of previously achieved weight-related and behavioural gains, rather than greater weight loss than comparator care, alongside consistently high feasibility and substantial reductions in healthcare visits and cost. Given the heterogeneity of designs and outcomes, findings should be interpreted as directional rather than pooled effect estimates, and a human component may be necessary to sustain them.
背景：控制体重和保持健康习惯对防治儿童肥胖至关重要。本系统综述考察了远程干预维持方案中BMI以外的结果，重点是维持健康的生活方式。方法通过PubMed、LIVIVO和Web of Science检索2012年至2025年11月4日期间的出版物，以确定评估在结构化肥胖治疗后超重或肥胖儿童和青少年的远程干预维持方案至少持续12周的初步研究。我们提取了健康的生活方式参数（如生活质量）、行为改变（如饮食）和临床报告的结果（如BMI）。根据研究类型进行质量评估。由于数据不允许进行元分析，我们进行了叙述综合。结果共筛选2543篇文章，获得6项随机对照试验和2项前后研究。研究结果强调了心理社会结果（如社会福祉）的改善，日常选择（如饮食模式）和行为（如屏幕时间）的生活方式改变，以及统计上显着的结果，包括体脂率降低，代谢谱改善，心血管增强和BMI稳定。还获得了可行性见解。结论：结构化儿童肥胖治疗后的远程干预维持方案与先前实现的体重相关和行为增益的稳定相关，而不是比比较组护理更大的体重减轻，同时具有一贯的高可行性和医疗就诊和成本的大幅减少。考虑到设计和结果的异质性，研究结果应被解释为方向性而不是综合效应估计，并且可能需要人为因素来维持它们。
{"title":"Effects of Teleintervention Maintenance Programs for Children (Age 6–12) and Adolescents (Age 13–18) With Overweight or Obesity—Promoting a Healthy Lifestyle: A Systematic Review","authors":"Anna Wittmann, Pia Späth, Feline Zocher, Eckard Nagel, Michael Lauerer, Magdalena Schellenberg","doi":"10.1111/ijpo.70158","DOIUrl":"https://doi.org/10.1111/ijpo.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Weight management and maintenance of healthy habits are crucial in combating paediatric obesity. This systematic review examines outcomes beyond BMI in teleintervention maintenance programmes, with a focus on sustaining a healthy lifestyle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PubMed, LIVIVO and Web of Science search was conducted for publications between 2012 and 4 November 2025 to identify primary studies evaluating teleintervention maintenance programmes of at least 12 weeks' duration, delivered to children and adolescents with overweight or obesity following structured obesity treatment. We extracted healthy lifestyle parameters (e.g., quality of life), behaviour change (e.g., diet) and clinician-reported outcomes (e.g., BMI). Quality assessment was tailored to study type. As data did not permit meta-analysis, we performed a narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Screening 2543 articles yielded 6 RCTs and 2 pre-post studies. Findings highlight improvements in psychosocial outcomes (e.g., social well-being), lifestyle modifications in daily choices (e.g., dietary patterns) and behaviours (e.g., screen time), and statistically significant outcomes including reductions in body fat percentage, metabolic profile improvements, cardiovascular enhancements and BMI stabilisation. Feasibility insights were also gained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Teleintervention maintenance programmes following structured paediatric obesity treatment were associated with stabilisation of previously achieved weight-related and behavioural gains, rather than greater weight loss than comparator care, alongside consistently high feasibility and substantial reductions in healthcare visits and cost. Given the heterogeneity of designs and outcomes, findings should be interpreted as directional rather than pooled effect estimates, and a human component may be necessary to sustain them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sydney Miller, Emma Sanchez-Vaznaugh, Brisa N. Sánchez
Objective
This study examines how ethnic disparities in childhood obesity differ across combinations of school ethnic composition and school neighbourhood income in California, to identify the contexts in which disparities are greatest. Prior studies have been unable to study this due to the high correlation between segregation and income.
Methods
This observational study focuses on overweight/obesity data objectively measured among California public school children in 2018/2019 and school neighbourhood data from the American Community Survey, using a ‘within versus between’ differences analysis.
Results
Black and Latino children had higher overweight/obesity prevalence than White children, but disparities varied across schools. Disparities were smallest in integrated low-income schools: the Black versus White (B/W) and the Latino versus White (L/W) disparities were 3% and 10%, respectively. In integrated high-income schools, these disparities were 8% and 13%, respectively. Disparities between segregated low-income schools and segregated high-income schools were 11% (B/W) and 14% (L/W), and 22% (B/W) and 26% (L/W). The largest disparity was between minority children in minority-segregated low-income schools compared to White children in White-segregated high-income schools (B/W disparity 23% and L/W 28%).
Conclusions
Place-based interventions to reduce childhood obesity should prioritize low-income, ethnically segregated schools, where the largest disparities were observed.
{"title":"Obesity Disparities in California Vary by School Ethnic Segregation and School Neighbourhood Income","authors":"Sydney Miller, Emma Sanchez-Vaznaugh, Brisa N. Sánchez","doi":"10.1111/ijpo.70157","DOIUrl":"https://doi.org/10.1111/ijpo.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines how ethnic disparities in childhood obesity differ across combinations of school ethnic composition and school neighbourhood income in California, to identify the contexts in which disparities are greatest. Prior studies have been unable to study this due to the high correlation between segregation and income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study focuses on overweight/obesity data objectively measured among California public school children in 2018/2019 and school neighbourhood data from the American Community Survey, using a ‘within versus between’ differences analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Black and Latino children had higher overweight/obesity prevalence than White children, but disparities varied across schools. Disparities were smallest in integrated low-income schools: the Black versus White (B/W) and the Latino versus White (L/W) disparities were 3% and 10%, respectively. In integrated high-income schools, these disparities were 8% and 13%, respectively. Disparities between segregated low-income schools and segregated high-income schools were 11% (B/W) and 14% (L/W), and 22% (B/W) and 26% (L/W). The largest disparity was between minority children in minority-segregated low-income schools compared to White children in White-segregated high-income schools (B/W disparity 23% and L/W 28%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Place-based interventions to reduce childhood obesity should prioritize low-income, ethnically segregated schools, where the largest disparities were observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Mediterranean Diet (MedDiet) is a plant-rich dietary pattern associated with favourable adiposity profiles, making it a relevant model for studying obesity risk in children and adolescents. This study aims to investigate the association between adherence to the MedDiet and risk of obesity in children and adolescents.
Methods
An extensive search in databases PubMed/Medline, Scopus, Web of Science Core Collection, the Cochrane Library and Google Scholar up to October 2025 was conducted. Cohort studies which reported means and standard deviations for the body mass index (BMI) levels and MedDiet adherence scores, and crude and adjusted odds ratios (OR) for overweight or obesity among the children with high and low adherence to the MedDiet were eligible for inclusion.
Results
Twenty three articles (26 studies) met the inclusion criteria. Results demonstrated that the mean BMI levels in children adhering to the MedDiet were significantly lower than those who did not adhere to it (weighted mean difference [WMD] = −0.42 kg/m2, 95% CI: −0.61, −0.23, I2 = 65.15%, p < 0.001). Additionally, results indicated that children with overweight had a lower mean adherence score compared to children with normal weight (WMD = −0.44 scores, 95% CI: −0.76, −0.12, I2 = 85.95%, p < 0.001).
Conclusion
This meta-analysis highlights that greater adherence to the MedDiet was associated with lower odds of obesity among children and adolescents. However, these findings should be interpreted cautiously because the evidence was entirely cross-sectional, heterogeneity was substantial across several pooled analyses and some estimates were sensitive to exclusion of individual studies.
{"title":"Adherence to the Mediterranean Diet Is Associated With a Lower Risk of Obesity in Children Under 18 Years: A Comprehensive Systematic Review and Meta-Analysis","authors":"Maryam Gholami Shahrbabak, Azam Gholami Shahrbabak, Artin Ebrahimi Meymand, Karen Tahmasebi Abdar, Maryam Mobasheri-Shiri","doi":"10.1111/ijpo.70154","DOIUrl":"https://doi.org/10.1111/ijpo.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Mediterranean Diet (MedDiet) is a plant-rich dietary pattern associated with favourable adiposity profiles, making it a relevant model for studying obesity risk in children and adolescents. This study aims to investigate the association between adherence to the MedDiet and risk of obesity in children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An extensive search in databases PubMed/Medline, Scopus, Web of Science Core Collection, the Cochrane Library and Google Scholar up to October 2025 was conducted. Cohort studies which reported means and standard deviations for the body mass index (BMI) levels and MedDiet adherence scores, and crude and adjusted odds ratios (OR) for overweight or obesity among the children with high and low adherence to the MedDiet were eligible for inclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty three articles (26 studies) met the inclusion criteria. Results demonstrated that the mean BMI levels in children adhering to the MedDiet were significantly lower than those who did not adhere to it (weighted mean difference [WMD] = −0.42 kg/m<sup>2</sup>, 95% CI: −0.61, −0.23, <i>I</i><sup>2</sup> = 65.15%, <i>p</i> < 0.001). Additionally, results indicated that children with overweight had a lower mean adherence score compared to children with normal weight (WMD = −0.44 scores, 95% CI: −0.76, −0.12, <i>I</i><sup>2</sup> = 85.95%, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis highlights that greater adherence to the MedDiet was associated with lower odds of obesity among children and adolescents. However, these findings should be interpreted cautiously because the evidence was entirely cross-sectional, heterogeneity was substantial across several pooled analyses and some estimates were sensitive to exclusion of individual studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mailén Rojo, Andrea Liliana Millán, Alejandra Beatriz Duarte, Andrea Elena Iglesias Molli, Gustavo Daniel Frechtel, Gloria Edith Cerrone, Hernán Pérez
Background
Childhood obesity increases chronic disease risk. Mitochondrial dysfunction, reflected by altered mitochondrial DNA (mtDNA) content and oxidative damage, has been implicated in obesity-related metabolic disorders, but paediatric data remain scarce.
Objective
To evaluate mtDNA content and oxidation in children with obesity, stratified as metabolically healthy (MHO) or unhealthy (MUO), compared with peers with normal weight (NW).
Methods
Cross-sectional study of 114 children aged 7–14 years: NW (n = 37), MHO (n = 40) and MUO (n = 37). mtDNA content was measured by qPCR, and oxidative damage as 8-oxoguanine by FPG-qPCR. Analyses included Student's t-test, one-way ANOVA with Tukey HSD, Pearson's χ2 and linear regression adjusted for age, sex and Tanner stage.
Results
Children with obesity showed elevated cardiometabolic risk, lower HDL-c, insulin resistance (IR), inflammation and significantly lower mtDNA content (−30.9%; p = 0.004) compared with NW, with no differences between MHO and MUO. Higher BMI was independently associated with lower mtDNA content (−3.72% per 1 kg/m2; p = 0.003), consistent across pubertal stages. In a multivariable model of metabolic syndrome components, HDL-c was independently associated with mtDNA content (β = 0.33; p = 0.016). Lower mtDNA content was also associated with IR and higher hs-CRP (B = −0.13; p = 0.028). mtDNA oxidation showed only a non-significant trend in obesity.
Conclusions
Lower mtDNA content was detectable in MHO and independently associated with HDL-c and subclinical inflammation. The absence of MHO–MUO differences suggests that chronic inflammation and IR, common to both phenotypes, may be the main factors associated with mtDNA variation at this age.
{"title":"Mitochondrial Dysfunction Markers in Paediatric Obesity: DNA Content and Oxidation Damage","authors":"Mailén Rojo, Andrea Liliana Millán, Alejandra Beatriz Duarte, Andrea Elena Iglesias Molli, Gustavo Daniel Frechtel, Gloria Edith Cerrone, Hernán Pérez","doi":"10.1111/ijpo.70153","DOIUrl":"https://doi.org/10.1111/ijpo.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Childhood obesity increases chronic disease risk. Mitochondrial dysfunction, reflected by altered mitochondrial DNA (mtDNA) content and oxidative damage, has been implicated in obesity-related metabolic disorders, but paediatric data remain scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate mtDNA content and oxidation in children with obesity, stratified as metabolically healthy (MHO) or unhealthy (MUO), compared with peers with normal weight (NW).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study of 114 children aged 7–14 years: NW (<i>n</i> = 37), MHO (<i>n</i> = 40) and MUO (<i>n</i> = 37). mtDNA content was measured by qPCR, and oxidative damage as 8-oxoguanine by FPG-qPCR. Analyses included Student's <i>t</i>-test, one-way ANOVA with Tukey HSD, Pearson's χ<sup>2</sup> and linear regression adjusted for age, sex and Tanner stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children with obesity showed elevated cardiometabolic risk, lower HDL-c, insulin resistance (IR), inflammation and significantly lower mtDNA content (−30.9%; <i>p</i> = 0.004) compared with NW, with no differences between MHO and MUO. Higher BMI was independently associated with lower mtDNA content (−3.72% per 1 kg/m<sup>2</sup>; <i>p</i> = 0.003), consistent across pubertal stages. In a multivariable model of metabolic syndrome components, HDL-c was independently associated with mtDNA content (<i>β</i> = 0.33; <i>p</i> = 0.016). Lower mtDNA content was also associated with IR and higher hs-CRP (<i>B</i> = −0.13; <i>p</i> = 0.028). mtDNA oxidation showed only a non-significant trend in obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lower mtDNA content was detectable in MHO and independently associated with HDL-c and subclinical inflammation. The absence of MHO–MUO differences suggests that chronic inflammation and IR, common to both phenotypes, may be the main factors associated with mtDNA variation at this age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chuanwei Ma, Jiachang Wei, Zhuo Gong, Suyun Li, Zhaolu Liu, Shoujuan Zheng, Lianlong Yu, Fei Li, Min Zhao, Gaohui Zhang, Bo Xi
Background
The relationship between secondhand smoke exposure and obesity is still a matter of debate, and few studies have considered the settings of exposure when exploring this relationship. We aimed to examine the associations of secondhand smoke exposure in different places with overweight and obesity among Chinese children and adolescents.
Methods
We used data from the Shandong Provincial Student Common Diseases and Health Influencing Factors Survey conducted in 2021. Secondhand smoke exposure in different places was assessed using a standardized questionnaire. The associations of secondhand smoke exposure with overweight and obesity were examined using multivariate logistic regression analyses. A total of 122 509 children and adolescents (boys: 51.3%) aged 8–18 years were included.
Results
The body mass index (BMI) level and the prevalence of overweight and obesity were higher among children and adolescents with exposure to secondhand smoke compared with those without exposure (BMI: 21.6 ± 4.7 vs. 21.1 ± 4.4 kg/m2; overweight: 20.8% vs. 20.0%; obesity: 21.1% vs. 18.8%). Children and adolescents with exposure to secondhand smoke were more likely to have overweight (in any place: odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.06–1.13; at home: OR = 1.10, 1.06–1.14; in school: OR = 1.09, 1.02–1.15; in other public places: OR = 1.06, 1.03–1.10) and obesity (in any place: OR = 1.19, 1.15–1.23; at home: OR = 1.21, 1.17–1.26; at school: OR = 1.27, 1.20–1.35 and in other public places: OR = 1.12, 1.08–1.16) after adjustment for potential covariates.
Conclusions
Secondhand smoke exposure was positively associated with overweight and obesity, regardless of exposure location. These findings underscore the importance of a collaborative effort for society, educational institutions and families to create a comprehensive smoke-free environment for children and adolescents.
{"title":"Associations Between Sources of Secondhand Smoke Exposure and Overweight and Obesity Among Chinese School-Aged Youth","authors":"Chuanwei Ma, Jiachang Wei, Zhuo Gong, Suyun Li, Zhaolu Liu, Shoujuan Zheng, Lianlong Yu, Fei Li, Min Zhao, Gaohui Zhang, Bo Xi","doi":"10.1111/ijpo.70152","DOIUrl":"10.1111/ijpo.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The relationship between secondhand smoke exposure and obesity is still a matter of debate, and few studies have considered the settings of exposure when exploring this relationship. We aimed to examine the associations of secondhand smoke exposure in different places with overweight and obesity among Chinese children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the Shandong Provincial Student Common Diseases and Health Influencing Factors Survey conducted in 2021. Secondhand smoke exposure in different places was assessed using a standardized questionnaire. The associations of secondhand smoke exposure with overweight and obesity were examined using multivariate logistic regression analyses. A total of 122 509 children and adolescents (boys: 51.3%) aged 8–18 years were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The body mass index (BMI) level and the prevalence of overweight and obesity were higher among children and adolescents with exposure to secondhand smoke compared with those without exposure (BMI: 21.6 ± 4.7 vs. 21.1 ± 4.4 kg/m<sup>2</sup>; overweight: 20.8% vs. 20.0%; obesity: 21.1% vs. 18.8%). Children and adolescents with exposure to secondhand smoke were more likely to have overweight (in any place: odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.06–1.13; at home: OR = 1.10, 1.06–1.14; in school: OR = 1.09, 1.02–1.15; in other public places: OR = 1.06, 1.03–1.10) and obesity (in any place: OR = 1.19, 1.15–1.23; at home: OR = 1.21, 1.17–1.26; at school: OR = 1.27, 1.20–1.35 and in other public places: OR = 1.12, 1.08–1.16) after adjustment for potential covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Secondhand smoke exposure was positively associated with overweight and obesity, regardless of exposure location. These findings underscore the importance of a collaborative effort for society, educational institutions and families to create a comprehensive smoke-free environment for children and adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burcu Uslu, Riley J. Jouppi, Danielle A. N. Chapa, Victoria E. Bell, Alissa Haedt-Matt, Andrea B. Goldschmidt
Background
Ultra-processed foods (UPFs) are increasingly prevalent in children's diets and linked to adverse health outcomes, yet factors driving UPF intake in youth remain unclear. Negative affect may be one factor.
Objectives
To examine associations between affective states and UPF intake in youth with overweight or obesity, using a laboratory study and a naturalistic study.
Methods
Study 1 included 46 girls (7–12 years) who completed counterbalanced negative and neutral mood inductions, followed by ad libitum access to a buffet of UPFs and minimally processed foods. Study 2 included 38 youth (8–14 years) who completed a 14-day ecological momentary assessment (EMA) protocol with repeated affect ratings and three 24-h dietary recalls. Foods were classified using NOVA; the outcome was percentage of energy from UPFs (%UPF). Study 1 used multilevel and regression models; Study 2 used lagged multilevel models.
Results
In Study 1, mood condition did not affect %UPF intake (F[1, 45] = 0.04, p = 0.843); however, within the negative mood condition, greater post-induction sadness predicted lower subsequent %UPF intake (b = −0.076, p = 0.015). In Study 2, affect did not prospectively predict subsequent %UPF intake, and %UPF intake did not predict subsequent affect (all p > 0.20).
Conclusions
Acute sadness was associated with reduced, rather than increased, UPF intake in the laboratory, while naturalistic affect did not predict UPF intake. Given the modest sample sizes, these null and unexpected findings should be interpreted cautiously and require replication before informing intervention design.
背景：超加工食品（UPF）在儿童饮食中越来越普遍，并与不良健康结果有关，但推动青少年摄入超加工食品的因素尚不清楚。负面影响可能是一个因素。目的：通过实验室研究和自然研究，研究超重或肥胖青少年情感状态与UPF摄入量之间的关系。方法：研究1包括46名7-12岁的女孩，她们完成了平衡的消极和中性情绪诱导，随后自由地享用upf自助餐和低加工食品。研究2包括38名青少年（8-14岁），他们完成了为期14天的生态瞬时评估（EMA）方案，重复影响评分和3次24小时饮食回忆。用NOVA对食物进行分类；结果为UPF的能量百分比（%UPF）。研究1采用多水平模型和回归模型；研究2采用滞后多层模型。结果：在研究1中，情绪状况不影响%UPF摄入量（F[1,45] = 0.04, p = 0.843）；然而，在消极情绪条件下，诱导后更大的悲伤预示着随后更低的%UPF摄入量（b = -0.076, p = 0.015）。在研究2中，情绪并不能预测随后的%UPF摄入量，而%UPF摄入量也不能预测随后的情绪（均p < 0.20）。结论：在实验室中，急性悲伤与UPF摄入量的减少而不是增加有关，而自然情绪并不能预测UPF摄入量。考虑到适度的样本量，这些无效和意外的发现应该谨慎地解释，并在为干预设计提供信息之前需要重复。
{"title":"Affective States and Ultra-Processed Food Intake in Youth With Overweight or Obesity: Evidence From Laboratory and Ecological Momentary Assessment Studies","authors":"Burcu Uslu, Riley J. Jouppi, Danielle A. N. Chapa, Victoria E. Bell, Alissa Haedt-Matt, Andrea B. Goldschmidt","doi":"10.1111/ijpo.70150","DOIUrl":"10.1111/ijpo.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ultra-processed foods (UPFs) are increasingly prevalent in children's diets and linked to adverse health outcomes, yet factors driving UPF intake in youth remain unclear. Negative affect may be one factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine associations between affective states and UPF intake in youth with overweight or obesity, using a laboratory study and a naturalistic study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Study 1 included 46 girls (7–12 years) who completed counterbalanced negative and neutral mood inductions, followed by ad libitum access to a buffet of UPFs and minimally processed foods. Study 2 included 38 youth (8–14 years) who completed a 14-day ecological momentary assessment (EMA) protocol with repeated affect ratings and three 24-h dietary recalls. Foods were classified using NOVA; the outcome was percentage of energy from UPFs (%UPF). Study 1 used multilevel and regression models; Study 2 used lagged multilevel models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Study 1, mood condition did not affect %UPF intake (<i>F</i>[1, 45] = 0.04, <i>p</i> = 0.843); however, within the negative mood condition, greater post-induction sadness predicted lower subsequent %UPF intake (<i>b</i> = −0.076, <i>p</i> = 0.015). In Study 2, affect did not prospectively predict subsequent %UPF intake, and %UPF intake did not predict subsequent affect (all <i>p</i> > 0.20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Acute sadness was associated with reduced, rather than increased, UPF intake in the laboratory, while naturalistic affect did not predict UPF intake. Given the modest sample sizes, these null and unexpected findings should be interpreted cautiously and require replication before informing intervention design.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian E. Saelens, Maya G. Rowland, Muna A. Ibrahim, Waylon Howard, Hareen Seerha, Susan J. Melhorn, Ellen A. Schur, Christian L. Roth
Introduction
Understanding within-treatment weight change patterns may inform strategies to improve long-term outcomes for children with overweight/obesity.
Methods
Latent class modelling was applied to weekly weight change among 294 7–11-year-old children with overweight/obesity in behavioural weight management trials. Class differences in BMI z-score change through 1 year after treatment were examined using strict class assignment among completers (ANCOVA) or accounting for uncertainty in class assignment and missingness (Bolck, Croon and Hagenaars or BCH method).
Results
Three classes emerged—larger loss to stable weight (6% of children), consistent modest weight loss (43%) and moderate to decreasing weight loss (51%). During follow-up, the consistent modest weight loss class showed minimal change in BMI z-score whereas the other two classes increased (difference with moderate to decreasing weight loss class in ANCOVA = −0.096, p = 0.05; difference with large loss to stable class in BCH = −0.144, p = 0.017). The consistent modest weight loss class had the most favourable change from baseline through follow-up, better than the larger loss to stable weight class (ANCOVA difference = −0.189, p = 0.080; BCH difference = −0.186, p = 0.015).
Conclusion
Three patterns of within-treatment child weight change emerged, with modest consistent weight loss associated with more favourable distal child outcomes.
{"title":"Patterns of Children's Weight Change During Family-Based Weight Management Intervention and Associations With Outcome Through Follow-Up","authors":"Brian E. Saelens, Maya G. Rowland, Muna A. Ibrahim, Waylon Howard, Hareen Seerha, Susan J. Melhorn, Ellen A. Schur, Christian L. Roth","doi":"10.1111/ijpo.70156","DOIUrl":"10.1111/ijpo.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Understanding within-treatment weight change patterns may inform strategies to improve long-term outcomes for children with overweight/obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Latent class modelling was applied to weekly weight change among 294 7–11-year-old children with overweight/obesity in behavioural weight management trials. Class differences in BMI <i>z</i>-score change through 1 year after treatment were examined using strict class assignment among completers (ANCOVA) or accounting for uncertainty in class assignment and missingness (Bolck, Croon and Hagenaars or BCH method).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three classes emerged—<i>larger loss to stable weight</i> (6% of children), <i>consistent modest weight loss</i> (43%) and <i>moderate to decreasing weight loss</i> (51%). During follow-up, the <i>consistent modest weight loss</i> class showed minimal change in BMI <i>z</i>-score whereas the other two classes increased (difference with <i>moderate to decreasing weight loss</i> class in ANCOVA = −0.096, <i>p</i> = 0.05; difference with <i>large loss to stable</i> class in BCH = −0.144, <i>p</i> = 0.017). The <i>consistent modest weight loss</i> class had the most favourable change from baseline through follow-up, better than the <i>larger loss to stable weight</i> class (ANCOVA difference = −0.189, <i>p</i> = 0.080; BCH difference = −0.186, <i>p</i> = 0.015).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Three patterns of within-treatment child weight change emerged, with modest consistent weight loss associated with more favourable distal child outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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